Importance of Infusion Volume and Pump Characteristics in Extended Administration of β-Lactam Antibiotics
Abstract
Importance of Infusion Volume and Pump Characteristics in Extended Administration of β-Lactam Antibiotics ▿ Barbara Claus * , Franky Buyle and Hugo Robays Pharmacy Department Dirk Vogelaers Department of Internal Medicine and Infectious Diseases Ghent University Hospital De Pintelaan 185, Ghent 9000, Belgium The introduction of a new protocol at Ghent University Hospital (Ghent, Belgium) for the extended administration of piperacillin-tazobactam (TZP) and meropenem drew attention to a potential pitfall that is well-known in daily clinical practice but often neglected, i.e., the contribution of infusion line dead space to the incomplete administration of the drug. The Antibiotic Policy Working Party at the institution implemented an extended 3-h protocol for TZP and meropenem administration in both intensive care units (ICU) and regular wards. The protocol specified that TZP is to be infused as a loading dose of 4.5 g over 30 min, followed by a 3-h infusion of 4.5 g every 6 h, with dosage adjustments according to renal function. For meropenem, a 1-g loading dose over 30 min is to be followed by a 3-h infusion of 1 g every 8 h. Dose regimens are based upon the Belgian version of the Sanford guide ( 5 ). Extended